Health-related Quality of Life after 76 Gy Intensity Modulated Radiotherapy for Localized Prostate Cancer: A Prospective and Longitudinal Study

Article Outline

• Purpose/Objective(s)
• Materials/Methods
• Results
• Conclusions
• Copyright

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Purpose/Objective(s) 

To study longitudinal quality of life after 76 Gy intensity-modulated radiotherapy (IMRT) in patients with localized prostate carcinoma.

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Materials/Methods 

From February to December 2006, fifty-five patients with localized prostate cancer were treated with IMRT and daily repositioning with the ExacTrac system to a total dose of 76 Gy with a Novalis linear accelerator. Quality of life (QoL) was measured by the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30 version 3.0), and the prostate specific EORTC QLQ-PR25, before radiotherapy (baseline) and at 2, 6, 18 months after treatment. QoL changes in time were considered clinically relevant if >10 points, and statistically significant if p < 0.01 using the Wilcoxon signed ranks test.

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Results 

Median age was 73 [54-80]. Patient distribution for cancer risk according to D'Amico's classification was: 18.0% low risk, 60.2% intermediate risk, 21.8% high risk. 45.5% patients received androgen deprivation therapy (ADT) for a median time of 6 months. QoL at 2 months showed significant deterioration in fatigue (+11.31, p = 1.10⁻⁷), urinary symptoms (+9.07, p = 3.10⁻¹¹), dyspnea (+7.27, p = 0.008), emotional functioning (−7.02, p = 0.002), social functioning (−6.36, p = 0.003), cognitive functioning (−4.85, p = 0.004), and role functioning (−3.39, p = 0.007). QoL at 6 months showed improvement for all parameters except in fatigue (+5.86, p = 0.003) and urinary symptoms (+5.86, p = 0.0004). QoL at 18 months is being assessed and updated data will be presented.

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Conclusions 

High-dose IMRT and accurate position verification allow to preserve a good QoL despite a temporary deterioration at 2 months. Subsequent more mature data at 18 months will be necessary to confirm our results.